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General NPI Number Information
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NPI Number | 1881899557
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Entity Type | Individual
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Provider Name | RUTUL SHAH M.D
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Gender | Male
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 150 KINGSLEY LN
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City | NORFOLK
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State | VA
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Zip | 23505-4602
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Country | US
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Telephone | 757-484-5900
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Fax | 757-483-6671
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Provider Business Mailing Address
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Address Line | 8580 MAGELLAN PKWY
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City | RICHMOND
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State | VA
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Zip | 23227-1149
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Country | US
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Telephone |
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Fax | 866-449-0896
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 0101253419
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 32541
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License Number State | SC
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